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Of Pesticides, Produce and PLU Codes

How many of us have taken our chances with something? Does it extend to your purchases of food? I would have to say most likely not. We check expiration dates, sell by dates; we visually examine food for signs of mold or bruises, or even bulging cans, which can indicate possible contamination. We hear about food product recalls and/or outbreaks and are vigilant about avoiding those foods. What can help us? The PLU Code of our food.

Pushing my cart happily through the grocery store (because I really don’t mind grocery shopping due to my love of all things culinary) I choose my produce selections for the week. I never gave the little stickers on most produce much thought, thinking they were just indications of the prices. That was until I came across an article that describes just what kind of information those same stickers contain.

The PLU Code, and How it’s Used

The PLU code is known as the Price Look Up and helps your friendly cashier identify what it is that you’re buying. But it doesn’t end there, as the PLU code can help you identify just where your produce originated and how it was grown.

  • Four Numbers: Only four numbers indicates that the produce was traditionally grown. That means pesticides were used. Those numbers refer simply to what kind of vegetable or fruit that you’re buying. For example, all bananas are labeled with a code of 4011.
  • Five Numbers: Five numbers that start with an “8” indicates that the item is genetically modified, or GMO. GMO foods are tampered with, meaning the produce was created in a lab and is not found in nature (just like all the photo-shopping of those gorgeous models in magazines…nope…not found in nature at all). So, as an example, a GMO banana would be 84011
  • Five Numbers (with a 9): Five numbers starting with a “9” refers to organically grown produce, so an organic banana would be

The most important number, of course, is the one that precedes the other letters and numbers as a guideline to how your produce is grown. However, if you’re really curious about knowing the numerical codes and letters of your apples, oranges, green peppers, etc., you can refer to the International Federation for Produce Standards (IFPS). This organization is composed of produce associations from around the world, and its objective is to “improve the supply chain efficiency of the fresh produce industry through developing, implementing, and managing harmonized international standards.”

“The Dirty Dozen” and “The Clean Fifteen”

One of the most critical ways that we as consumers can safeguard our health and make informed decisions is to adapt a proactive state of mind when it comes to choosing any type of food that we purchase. This naturally extends to our topic of produce, and whether or not the use of pesticides on such crops is sufficiently important to our decision. The Environmental Working Group (EWG) is a non-profit, non-partisan organization that advocates for living a healthier life through healthier choices through research and civic action.

According to this website, there is a list of produce products that exemplify the best and the worst in terms of pesticide application and it is as follows:

The Dirty Dozen

  • Strawberries
  • Apples
  • Nectarines
  • Peaches
  • Celery

Strawberries clearly top this list with an average of almost eight different pesticides per USDA sample (all other produce had an average of two per sample). Strawberry growers utilize some types of poisonous gases, and strawberry fields are drenched with chemicals meant to sterilize them before planting and are meant to kill every pest, weed and virtually every living thing that exists in the soil. What is equally as mind-boggling is that the USDA strawberry tests revealed that 90 percent of the samples had detectable residues of at least one pesticide. According to the researchers at EWG,

“The EPA’s tolerance levels are too lenient to protect public health. They are a yardstick to help the agency’s personnel determine whether farmers are applying pesticides properly. The levels were set years ago and do not account for newer research showing that toxic chemicals can be harmful at very small doses, particularly when people are exposed to combinations of chemicals”.

Once upon a time, consumers couldn’t purchase strawberries save for a specific season, and they were in limited supply. During the past decades, pesticides and other chemicals that are added to improve growth have only served to make strawberries available year-round. The average American eats almost four times as many strawberries as they did in 1980: an incredible eight pounds per year.

There’s quite a lot more information relevant to pesticide usage and strawberries as well as other produce that can be found on the EWG website.

The Clean Fifteen

Differentiated from produce that is laden with pesticides are those that are not as profusely employed:

  • Avocados
  • Sweet Corn
  • Pineapple
  • Cabbage
  • Frozen Sweet Peasor

As for the amazing avocado, only one pesticide was found in a sample count of 360 avocados. Less than two percent of sweet corn samples had any pesticide residue. Again, for an exhaustive and easy-to-read description of all types of common produce and its relation to pesticide use, please consult the EWG website.

What’s the Best Way to Rid Produce of Pesticides?

As a point of discretion, even though the EWG’s aforementioned lists would have us conclude that we are eating pesticide laden produce; the Journal of Toxicology cautioned in a rebuttal to the EWG’s results that their methods were not so scientific. The journal alluded that the levels of pesticides that were detected in the “Dirty Dozen” list all fell below the acceptable limits established by the Environmental Protection Agency. It is important to consider that legal limits aren’t infallible, and that impacts on the human body are sometimes difficult to study. If uncertainty about this plagues you, you may want to purchase organic, or even make a trip to your local farmer’s market (I do, and I love their perfectly imperfect produce)!

In order to ameliorate the effects of any residual pesticides, a basic scrub with tap water will help a little, but some fruit skins such as apples that are treated with wax, will retain the pesticides despite a hard scrub. Even store-bought fruit and veggie washes are not effective, and regular soap is prone to seep into surfaces. However, according to a recent study in the Journal of Agricultural and Food Chemistry, a solution of baking soda and water can remove even more pesticides than water alone. For example, in the experiment, Gala apples were soaked in a baking soda mixture for eight minutes and had significantly less residue. At 12 to 15 minutes there were virtually no pesticides remaining. Baking soda helps to degrade certain kinds of chemicals, but it doesn’t react with some of the other pesticides used.

By:  Kerry Bazany, Contributing Writer (Non-Lawyer)

October 3, 2018
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Restaurant Food Fraud: When It Says Organic, But the Product Says Otherwise

Organic foods have seen a rise in the past several years and have become a big business with homes across America using more and more organic foods in their daily lives. A whopping 82% of families consume $45 billion in organic foods per year. The issue with this is that while consumers are looking for organic foods, many restaurants are labeling themselves as being organic without seeking the certification that is required to be fully organic.

Can you imagine the surprise when a customer at a burger restaurant called Bareburger, which labeled itself as organic, noticed a truck being unloaded with beef that was not labeled as being organic? They were found to be using both organic and a blend of beef which was 20% – 25% non- organic.

Why is this so important? Well first and foremost I like to get what I am paying for. We locally source our own beef to make sure that it is raised the way that we like and when dining out if I believe I am getting organic meats then I want to be sure they are what they claim to be. Secondly, the Bareburger customer who brought up the non-organic beef needed to be sure where his foods were coming from since he had an operation that left him prone to infections and more likely to choose organic foods over others.

Gil Rosenberg made it a point to contact the store management and let them know about his sighting of the unloaded truck and was told that the burgers were “made with organic” beef which doesn’t allow for the organic label per the USDA. Many consumers would just hang their hat and not go back to that establishment but according to an article in the NY Times Mr. Rosenberg went further.  Going through the trash at Bareburger, Gil Rosenberg found that condiments and even tomatoes were not labeled organic.

But is all of this illegal? While farms and other businesses that want to advertise their wares as organic have to answer to certifying organizations that conduct annual inspections for the Department of Agriculture, restaurants do not. A restaurant can seek organic certification if it wants, but is not required to.

Under the department’s current rules, restaurants (characterized as “retail food establishments”) may call their food organic if they have made what Jennifer Tucker, the deputy administrator of the National Organic Program, called a “reasonable” effort to use organic ingredients.

There is no precise definition, however, of what constitutes a reasonable effort, and no monitoring body for enforcement. If the department receives a complaint that a restaurant is falsely billing its food as organic, Ms. Tucker said, it will investigate the claim and if necessary, send a letter asking the owner to stop using the term.

In 2002, the Department of Agriculture started the National Organic Program to create uniform standards, like not using synthetic fertilizers or genetic engineering, for farms and other businesses that produce, handle or process food. To enforce the rules, the agency works with organizations that assess and certify compliance.

Restaurants were exempted, Ms. Tucker said, because the biggest concerns at the time were farming practices and food production. The certification process is expensive, and it was thought that requiring compliance might impose too heavy a burden on restaurateurs.  Besides, “there weren’t a lot of restaurants making organic claims,” said Connie Karr, the certification director of the nonprofit organization Oregon Tilth, which certifies businesses as organic. “I assume that back then, it just wasn’t an issue.”

How Did Bareburger React?

At Bareburger, Mr. Pelekanos said he started using the term because he was trying to buy organic ingredients whenever possible and wanted to draw attention to that. Three and a half years ago, he said, he started buying 100 percent organic beef from Vermont Country Farms in addition to a 75-to-80-percent organic blend from Pat LaFrieda. The restaurants have used both, “based on market pricing, flavor, consistency and availability,” a Bareburger spokesman said, but for now are serving only the all-organic beef. (Agriculture Department guidelines for farms and other businesses say a product must contain at least 95 percent organic ingredients — excluding salt and water — to be labeled organic.)

Mr. Pelekanos said he had never claimed that all of Bareburger’s menu items were 100 percent organic. And he has no plans to seek certification for any of the 41 Bareburger restaurants in the United States.

But at some newer Bareburger locations, words like “local” and “sustainable” — and in certain cases no words at all — have replaced the word “organic” near the logo. “We’re not moving away from the word,” Mr. Pelekanos said, but “we are adding more descriptors of our brand.”

Mr. Pelekanos said he didn’t think Bareburger needed to stop using “organic” entirely. “Why are we going to run away from a word, when we have spent so much time and energy over the years to serve so much organic food in our restaurants, and we charge a premium for it?” he asked.


Many places find that becoming 100% organic is too involving. The challenges often outweigh the benefits when it comes to being an organic restaurant. On top of the already tough demands of food inspections and other health related classes that must be taken when it comes to being organic there are intense records that have to be kept as well as extensive training that all employees must go through. There are also fees associated with becoming and staying organic in the food industry and with mounting costs in other areas this is just not something a lot of restaurants can afford. It is said that many inquire, but when presented with the list of obligations they end up changing their minds and only go partially organic or just serve regularly sourced foods.

We end up preparing a lot of foods at home to be sure we know where the ingredients come from and there are a few restaurants here who serve locally sourced meats and vegetables, but none that are 100% organic to my knowledge because of the demanding set of rules. Eat with caution.

By: Samantha Cooper, Contributing Writer (Non-Lawyer)

September 27, 2018
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The Second Battle of the Bulge: Food Addiction Fast Foods Edition

I believe that with few exceptions, most of us would look at the picture above and exclaim “Oh that looks soooooo good”! It’s almost a knee-jerk reaction due to years of conditioned responses delivered by countless and relentless media messages. It’s almost abnormal not to covet anything to do with food laden with salt, sugar, fat, and additives that we cannot even pronounce. This article is part one of a three part series on fast food and processed food. Today, we are discussing food addiction fast foods edition.

I am as guilty as all-get-out when it comes to my love of fast food, but it wasn’t always that way. I grew up in the 60’s and wore out my adolescence in the 70’s, but I cannot recall going to a McDonald’s until I was almost ten years old. I bit into my first cheeseburger and was immediately hooked. It happens just like that. But before that, my Irish grandmother would cook up magnificent homemade meals. Not a single processed addition: just the traditional, well-rounded meat, potato, and vegetable. I don’t remember snacking on that many chips, and more often than not I ate apples for snacks.

It Didn’t Start With McDonald’s

The first “fast food” meal was probably served in ancient Rome, where many people lived in apartment buildings that were multi-storied, much as they are today. Cooking areas were scarce, so street vendors and restaurants fed lots and lots of people.

Even in colonial America, the colonists loved to sit and chat while dining, but as soon as they were done, they left to return to work. This is a reflection of the well-established Protestant work ethic that defined the American people, as in valuing time too well to waste it at the table!

A Brief Timeline of Fast Food

1921 – The first fast food hamburger chain, White Castle, was founded in Wichita, Kansas.

1955 – McDonald’s was founded by Ray Kroc in Des Plaines, Illinois. By 1958, Ray Kroc sold his 100 millionth hamburger. McDonald’s is one of the most influential and successful fast food franchises in history.

1967 – The Food and Drug Administration introduced high fructose corn syrup, initially intended to replace processed sugar. We now know that the body metabolizes it just as it does sugar, and it is equally as unhealthy for you. High fructose corn syrup was used in fast foods and to sweeten drinks.

1969 – President Nixon organized a conference on Food, Nutrition, and Health to address issues of American malnutrition. The goal was to draw up a national nutrition policy and devise steps to implement it.

1973 – The FDA created nutrition labeling regulations on food. These were intended to provide nutrition facts to consumers.

1989 – Wendy’s introduced their 99 cent Super Value menu. It included popular items at a reduced price.

2004 – A documentary produced by Morgan Spurlock debuted. It was controversial in its scope because it featured Spurlock eating only McDonald’s food for 30 days and explored the fast food industry with its unhealthy food options. Because of the film, McDonald’s took its super-size options off their menu.

Get in the Car Now, or How About a Cheeseburger Before Practice?

Yet the history of the rise of American fast food is inextricably linked to the Industrial Revolution, then to the increase of women with children in the work force. If you think about it, we as a society were far healthier because of the physical activity that we had to perform: think daily chores, farming, taking care of children, lots of physical labor daily. With the Industrial Revolution, the swing to automation began to take shape and form in less and less physical activity. Nowadays we have the gym as a substitute for what once came naturally, and many of us are not so vigilant about even that. To make matters worse, we are so crunched with time restraints that on the way to the gym we’ll sometimes grab fast food and justify it by saying that we’ll “work it off”. To complicate matters further, the advent of the “working mom” put an additional strain on time availability to cook meals. It became far easier to just grab some fast food from a nearby drive-through.

Not only is it a matter of convenience, but fast food is relatively inexpensive. When family budgets are tight, fast food is a cheap alternative. Many fast food chains offer “dollar” menus or bundled deals that make it easy to purchase many foods.

The Science Behind Fast Food: So Our Brains are to Blame?

We are all well aware of the precepts that we should follow when it comes to what we consume: less fats, sugars, salt. Nutritionists, physicians, even our families, tell us to exercise more self -control, and everything in moderation. The theory makes complete sense, but is it valid?

Science has offered conclusive evidence that industrially produced processed food that are laden with sugar, fat, and salt are actually biologically addictive. According to Dr. Mark Hyman, Director of Cleveland Clinic’s Center for Functional Medicine, food that is made in a plant rather than grown on a plant, is more addictive. For example, I know of no one that, given a choice between a bowl of broccoli and or a bag of potato chips, a plate of cookies, or a pint of ice cream would choose the former. To offer another analogy, ask a cocaine addict to “just say no” after that first snort. Ask an alcoholic to do the same after a drink. It’s not a choice but a biological directive that promotes addictive behavior.

What’s Coming

In a subsequent article to be published here, I will provide information on the Big Food companies and their link to fast food and obesity. Also look for more information regarding a more complete understanding of just what makes us crave what we shouldn’t be craving and how powerless we are, biologically, to stop it.

The obesity crisis and its resultant medical conditions deserve just as much attention as the recalls and outbreaks that we publish here at Make Food Safe. Both are at opposite ends of the spectrum of food safety, however, being proactive characterizes both schools of thought when it comes to dealing with eating foods that are unhealthy for us and utilizing the best in food safety practices.

By: Kerry Bazany, Contributing Writer (Non-Lawyer)

September 3, 2018
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A FSMA Shakeup in the Future?

The Trump administration has proposed a reorganization of the federal government that would dramatically change the way that food safety is handled. The plan seeks to consolidate the various agencies that regulate food in the United States so that their functions are housed under a single roof.

This is Not a New Idea; But is the Change a Good Idea?

That would be a big change from how the United States presently handles food regulation at the federal level. Right now, there’s two big agencies that do that. the United States Department of Agriculture deals with meat, poultry and catfish through their Food Safety Inspection Service. The Food and Drug Administration, meanwhile, is the subdivision of the Department of Health and Human Services that regulates every other kind of foodstuff.

The current proposal suggests a streamlining that would see the functions of the FSIS and the FDA consolidated under a single roof. The new entity would be called the Federal Food Safety Agency and would operate under the USDA. Although the FDA would no longer regulate food, it would still be charged with the regulation of drugs, dietary supplements, and medical devices, and be reorganized as the Federal Drug Administration.

This is not exactly a novel idea. The Obama administration also sought to reorganize how food is regulated by consolidating the functions of the FDA and the USDA. They sought to consolidate in the opposite direction, however; rather than choosing the USDA as the single agency to regulate food, the Obama administration had hoped to streamline the regulatory framework by transferring the USDA’s meat-related responsibilities to the FDA.

Ultimately, Obama’s proposal to streamline the USDA and FDA stalled and died at the hands of a Republican-controlled Congress that was loathe to hand him a legislative victory. What we got instead was the Food Safety Modernization Act, or FSMA. It granted the FDA mandatory recall authority, amongst other new powers, and restructured large parts of the legal framework through which the FDA regulates most foods. It did not consolidate the FDA and the USDA, as the Obama had originally sought to do.

The distinction between that unsuccessful consolidation and the current proposal by the Trump administration is an important one. To understand why, we need to take a closer look at the USDA, which operates somewhat differently than other branches of the federal government.

The Breakdown

The USDA, you see, isn’t just an agency that regulates agriculture. It’s also charged with the promotion of agriculture. These two different objectives are sometimes in tension with one another. Critics say that the USDA can’t properly regulate agriculture if they’re also in the business of promoting it. They say that the USDA is too closely tied to the business of agriculture; that it receives too much money from agribusiness titans like Monsanto, and that employees like department head Sonny Perdue are compromised by their experience in and connections to Big Ag. It’s also been alleged that the USDA has no business carrying out some of the functions that it’s been charged with, like issuing guidelines about what people should and shouldn’t eat. One food industry observer quoted by Time Magazine said that “tasking the government agency that manages America’s food production with crafting nutrition policy is akin to “putting the fox in charge of the hen house.”

The Good and the Bad

The key distinction between Trump and Obama’s proposed reorganizations, then, is that shifting regulatory power to the USDA might strengthen the financial connections between agriculture and the federal government, while shifting it to the FDA, as Obama unsuccessfully tried to do, might weaken those ties. The Trump administration move would expand the dual mission of promotion and regulation at the USDA from meat, poultry, and catfish to the entire food system.

That could act as a booster for the agriculture industry, kick-starting growth by opening up levers of power for farmers to shape legislation at the federal level. Streamlining the system that we have for regulating food could eliminate redundancy, eliminate bloat at the federal level, and save millions of dollars. It would also bring the US in line with their international peers in Canada, the United Kingdom, and the European Union, all of which have reorganized and consolidated their food safety regulations in the recent past.

It could also weaken the regulatory environment for food overall. If the food industry and the agency charged with regulating them are bound to one another by too many financial and interpersonal ties, then it stands to reason that groups or individuals within the food industry could exploit those ties in order to shape the regulatory framework around their business as they see fit. Stack the agency that’s charged with regulating food with former industry executives, and it’s possible that the agency will take a softer stance towards violators than they otherwise would have.

At the moment, the hopes of a leaner, more efficient food inspection regime in the United States are just that – hopes. The plan to consolidate the FDA and the USDA are part of a larger proposed reorganization of several different departments of the federal government. That reorganization can’t be executed unilaterally; to achieve the reorganization, Trump needs the consent and assistance of Congress. So, for now, the plan heads towards a politically uncertain future. The proposed USDA/FDA consolidation is a slim part of the overall plan, taking up just a few pages, and it’s light on details.

According to an article by Quartz, “Right now the federal government spends close to $2.3 billion a year on food-safety programs. The USDA employs about 9,200 people to handle meat inspections with an annual budget of $1 billion. The FDA handles just about everything else with an annual budget of $1.3 billion and 5,000 employees. Trump’s proposed plan does not indicate budgeting or staffing would be cut.”

It does not include specifics as to whether the $2.3 billion budget or 14,000+ employees at the two agencies would be affected. We will just need to wait and see.

By: Sean McNulty, Contributing Writer (Non-Lawyer)

August 30, 2018
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Labeling GMOs

After months of public input and deliberation, the USDA has released their proposal for labels on genetically modified foods. The proposed guidelines are open for public comment until July 3rd, and would go into effect in 2020.

What is on the Horizon

The new guidelines don’t use the language “genetically modified,” however. The USDA wants to move away from that term because it’s been the center of much debate, and is freighted with associations that might unfairly put off a shopper from choosing products whose genetic material has been tweaked. The new appropriate language is “bioengineered,” or BE; it’s meant to sidestep the somewhat charged associations of GMO.
Foodmakers will have a few different options for how they can label bioengineered products under the proposed guidelines. One label is a badge-like circle that says “BE” in stylized letters

A second option is putting text on the packaging that states outright the food contains one or more bioengineered ingredients.

“Excluding highly processed GE foods would mean that consumers would be wrongly left in the dark about thousands of GE products,” said Bill Freese, The Center for Food Safety’s Science Policy Analyst. “These products, as well as those from newer forms of genetic engineering, must be subject to mandatory labelling if this rule is to be meaningful.”

A third option is putting a QR code on the packaging which can be scanned with a smartphone to call up more information about the product.

The QR code option has not been entirely well received. About a third of the population in the United States doesn’t have access to a smartphone. Those people are more likely to be poor, elderly, and rural – people who already are already likely to have limited choices when it comes to food at the supermarket, and who thus might be further disadvantaged by labels that require expensive technology like a smartphone just to read.

To Label or Not to Label

The question of whether or not to label genetically modified food is complicated and the subject of much debate. So far, decades of research and thousands of studies have not yet shown that selectively modifying the genes of corn, soybeans, or rice causes health problems in those who consume those crops.

“This rulemaking presents several possible ways to determine what foods will be covered by the final rule and what the disclosure will include and look like,” said Agriculture Secretary Sonny Perdue. “We are looking for public input on a number of these key decisions before a final rule is issued later this year.”

Advocates of GMO crops have pushed back against the possibility of labels for food that’s genetically modified. Because negative health outcomes have not been demonstrated in the scientific literature, they say, it’s unfair to label the food as genetically modified. Labelling may discourage consumers from buying genetically modified products, or imply that there is risk where current science suggests there is none.

GMO skeptics say that we don’t yet have enough data to know whether modifying crops can produce long-term health effects and should maintain our skepticism. Labelling, the argument goes, is a neutral good; it provides the consumer with more information, which is always a good thing. People should be able to make informed decisions about what they’re buying, and putting labels on genetically modified crops makes those decisions more informed.

What is Being Labeled?

Not all products derived from genetically modified foods are subject to the new regulations. According to the Genetic Literacy Project, crops with small genetic changes that could be achieved through selective breeding or natural mutation are exempt from the proposed regulations. The same is true for products whose principal ingredient isn’t GMO, but which might contain small amounts of other ingredients derived from genetically modified plants. So are byproducts like sugar and oil that are derived from genetically modified plants but contain little or no genetic material after they’ve been subject to processing.

That measure is also somewhat controversial. Organizations who are critical of bioengineered foods, like the Center for Food Safety, have claimed that excluding highly processed products from the new labeling requirements will leave consumers unfairly in the dark. Regardless of the technology used or the amount of processing applied afterwards, they say, ingredients or foods whose genes have been tweaked should have labels saying as much.

Proponents of bioengineered foods might say that there’s much more distance between coconuts and oil extracted from them than there is between an unmodified fruit and one that’s had a single genetic sequence tinkered with. The gist of this argument is that natural processes do much more to disturb DNA than selective gene-editing techniques do.

It goes something like this: the division of cells in the genome  of any given living thing introduces transcription mistakes, duplications, omissions, re-arranging, and other errors into the DNA. Chromosomes are bombarded with cosmic radiation over time, which can create rips, tears, and holes in the genetic record by smashing into it at scales too small to properly imagine. All of these changes are arguably greater, and freighted with the possibility of harm, than the precisely guided selective editing that’s achieved through techniques like CRISPR.

If you follow that line of thinking, it might seem like we need a warning label for every living thing. Most of those changes happen to “junk DNA” – the vast stretches of the genetic code that don’t seem to serve any purpose. It’s relatively rare for damage or a copying error to affect useful genetic instructions space out through the filler. Because deliberate bioengineering is targeted, it always is focused on active and useful genes. Thus, the capacity for unintentional consequences is greater than that of random mutation.

The Great Debate Isn’t Over Yet

The debate over the safety of bioengineered foods, and appropriate ways to label them, isn’t about to end. The comment period for the USDA’s proposed labelling guidelines is, however. If you have something to say about them, reach out before public comment closes on July 3rd.

By:  Sean McNulty, Contributing Writer (Non-Lawyer)

August 2, 2018
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Get Some Culture: A Guide to Culture Independent Diagnostic Tests vs Benefits of Culture

Doctors and Epidemiologists share some common goals, but sometimes their perspectives diverge.  Doctors and Epidemiologist alike want to identify what is making patients sick so that they can receive the appropriate treatment.  Each would also like this answer as soon as possible.  The Doctor has a responsibility to his or her own patient, while the Epidemiologist has a responsibility to the community.  This is where their paths often fork.  Or rather, where the Doctor’s participation tapers off and the Epidemiologist participation picks up.

Doctor’s Choice for Diagnostics

Doctors have many choices when it comes to diagnosing the specific bug ailing their patient.  They can request from a variety of fast kits which are Culture Independent Diagnostic Tests or CIDTs or opt for a longer, but more thorough culture confirmation tests.  CIDTs are faster, but the culture confirmation tests have much more information.

CIDTs vs Culture

Let’s take a look at the differences between CIDTs and culture confirmation tests.

CIDTs can provide results in as little as a few hours and can even be performed in-house.  These tests often require less expensive equipment and less training for the test to be performed, thus reducing the overall cost of the tests.  CIDTs often detect antibodies or proteins that the bacteria produce very specific to a particular organism.  While the detection process may only take a few hours, bacteria count in the sample might be too low for the minimum detection limit.  These tests often take that into account offering a pre-enrichment step where the culture is allowed to grow for a short period of time – just enough to boost bacterial count to detectable levels.  This increases the result turn-around-time, but not significantly.  For a doctor who is trying to rule out different causes that might produce the same symptoms but would require different treatment depending on the result, CIDTs are a fast solution.

Cultures provide much more information in addition to organism identification.  Cultures allow the investigator to determine if the organism is alive or dead.  This makes a huge difference when it comes to identifying if the organism is what is making the patient sick.  Additionally, genomic information and DNA fingerprints can be obtained from growing the culture and purifying isolated DNA from the sample.  This allows for very specific data collection.  There are many strains or versions of the same organism.  Obtaining the DNA whole genome sequence of the pathogen responsible for making the patient sick allows investigators to compare the minor differences to others who are also sick with the same pathogen.  If the DNA fingerprints match, the two patients were likely sickened from the same source.  Taking cultures to make isolates and performing DNA fingerprinting analysis on potential food sources that come in in patient interviews will allow investigators to definitively determine what food is the source and appropriate agencies can issue recalls as necessary.

Epidemiologist Choice for Monitoring

While CIDTs allow fast surveillance at the local medical care level, unless this information is passed on to the local or state health departments it stays under the radar.  Epidemiologists often request that a sample be submitted for culture confirmation and analysis even though the pathogen has been identified and appropriate medical intervention has begun.

Once diagnosed, the process should not stop there.  Epidemiologist want to help prevent others in the community from falling ill from the same source if possible.  DNA fingerprinting allows for monitoring disease trends and outbreak investigations.  When healthcare providers stop at their end of diagnostics, it leaves a lot of information off the table when it comes to where epidemiology picks up.

CIDT Trends Affecting Epidemiology

This shift toward CIDTs and away from sending samples for culture and bacterial isolates has significantly affected the effectiveness of outbreak investigators.  The decline in culturing has become measurable.

FoodNet, also known as “The Foodborne Diseases Active Surveillance Network,” has been around since 1996.  This organization tracks foodborne illness trends for commonly transmitted infections.  According to the organization, FoodNet “estimates the number of foodborne illnesses, monitors trends in incidence of specific foodborne illnesses over time, attributes illnesses to specific foods and settings, and disseminates this information.”  According to FoodNet, Campylobacter diarrheal illness that was diagnosed by ONLY CIDTs in FoodNet sites showed an increase from 13% in the years of 2012 to 2014 to 24% in 2015 alone.

Potential Short-Term Solutions

The Center for Disease Control and Prevention (CDC) is soliciting the help of clinical laboratories to prevent this loss of information.  Together the two groups can come together to achieve a desired result that does not compromise patient care, but also does not compromise outbreak monitoring activities.

  • The CDC is encouraging clinical laboratories to continue culturing and isolating bacteria from patients who test CIDT positive for specific bacterial pathogens. This includes: Salmonella, Shiga toxin-producing coli, and Shigella.  Select laboratories are also requested to culture Campylobacter positive specimens.
  • The CDC is working to make the culture process a cheaper and easier for the clinical laboratories to encourage clinical laboratories to continue this practice.
  • The CDC is working with various organizations including the Association of Public Health Laboratories, regulatory agencies, public health officials, diagnostic laboratories, clinicians, and even CIDT kit manufacturers to be sure that cultures can be and are obtained so that public health laboratories have isolates to work with in the event CIDT produces a positive result.
  • One of the ways the CDC is working with CIDT manufacturers is encouraging them to design tests that keep the bacteria alive so that the sample can be cultured from it if the test produces a positive result.
  • As CIDTs are here to stay, the CDC is also working with surveillance systems (such as FoodNet and PulseNet) to update practices to include CIDT diagnosed results in their monitoring networks.

Potential Long-Term Solutions

The fast turn-around-time benefit of CIDTs is too great for the method to go away anytime soon.  At least until a better method becomes available.  Long-term, the CDC must come up with a compromise to avoid loss of the important genetic information.

The CDC is working to develop that next level diagnostic test.  One that is both fast but does not require bacterial isolates to obtain additional information.  Potential upstream information such as likelihood for antibiotic resistance and more specific information about the pathogen are some of the value-added aspects.

By:  Heather Van Tassell, Contributing Writer (Non-Lawyer)

July 29, 2018
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History Made – FDA Demands Recall Due to Salmonella

Food recalls have become a common trend that occurs throughout the year.  They can cause massive hysteria and send consumers into a state of panic.  Consumers expect a product they’ve purchased to be safe but oftentimes a product that has been recently purchased or previously purchased can be recalled for various reasons – like what we have seen with Salmonella and Kratom products.  Most products are recalled because they have the potential to make someone sick or it could have metal or glass shards inside of it.

The U. S. Food and Drug Administration (FDA) often work with companies when there has been a suspected contaminated item.  It allows the companies to voluntary recall the item while issuing a recall classification to the public.  Most companies are all about consumer safety and have no problem with issuing recalls.


In April 2018, the FDA set a new precedent by issuing their first ever mandatory recall.  Triangle Pharmanaturals was given an opportunity by the FDA to voluntary recall some of their kratom herbal supplements.  The supplements tested positive for salmonella.  The company was informed that their product had tested positive for the bacteria which could make their customers sick.  The FDA requested for the company to voluntary recall but the company refused.  No one knows why Triangle Pharmanaturals refused to recall their product.

Triangle Pharmanaturals is a Las Vegas-based company.  Kratom is advertised as an all- natural, herbal product that is made from a plant that’s native to Southeast Asia.  It is commonly used for pain relief, anxiety, and depression.  It is used to help opioid addicts wean off opioids because it resembles the drug but does not trigger respiratory depression.

The FDA used their power granted to them under the 2011 Food Safety and Modernization Act, which gives them the right to regulate dietary supplements as food.  Previously the FDA started the mandatory recall process for three separate companies, but this is the first times they’ve  enforced it.


The Drug Enforcement Administration has threatened to ban kratom for the past two years.  The FDA is concerned that kratom can expose users to the risks of addiction, abuse, and dependence.  They want to make it illegal like heroin and marijuana.  The FDA has issued an updated recalled list on their site which list over 20 kratom supplements affected by the recall.  The FDA advises consumers to immediately dispose of these products.


Products containing kratom have been linked to a multi-state outbreak of Salmonellosis. The Center for Disease Control and Prevention (CDC) reported 87 cases linked to kratom with 27 hospitalized.  However, the bacteria strain of salmonella found in Triangle Pharmanaturals’ products are not linked to the outbreak.


Salmonella infections are quite common.  In fact, they are among the most common forms of food poisoning in the United States, next to Campylobacter and Norovirus. The CDC says 10 million cases are reported every year. And that is not counting the fact that it is underreported – for every 1 confirmed case of Salmonella, there are typically 29 not reported.

Salmonella is the bacteria that causes Salmonellosis.  Salmonella can come from several sources.  The most common way to get a salmonella infection is by eating meat, eggs or drinking milk.   Salmonella can be found in poultry, beef, veal and pork.  It can also be found in the fertilizer that comes into contact with other foods such as fruits and vegetables.  Human contact and cross-contamination at home are other sources of salmonella infections.  Salmonellosis is more common in summer than winter because food gets hot faster making it a perfect breeding ground for foodborne bacteria.

Most people can get over a salmonella infection without treatment, but in severe cases, the infected person may need to go to the hospital.  Symptoms usually do not last more than a week.  Most symptoms of salmonella infection are stomach-related:

  • Cramps in stomach
  • Bloody stools
  • Diarrhea
  • Cold and Chills
  • Fever
  • Headache
  • Throwing up

Infected person should seek immediate medical assistance if they feel pain in their joints, pain in their eyes or if they experience symptoms of dehydration.  Signs of dehydration include:

  • Peeing only in small amounts
  • Dry tongue and mouth
  • Sunken and dry eyes

Salmonella infection can be very serious if it gets into the infected person’s blood.  It can possibly infect the body’s tissue causing infections in places such as:

  • The tissue around the brain and spinal cord
  • The lining of the heart and heart valves
  • The bone or bone marrow
  • The lining of blood vessels

A medical professional may test the infected person’s blood or stool to diagnose salmonellosis.  They may even go a step further and possibly identify the exact kind of bacteria the patient has.  That can be helpful when tracing the source of an outbreak in the area.

Treatment for Salmonellosis can vary depending on the age of the infected person, the specific type of bacteria found in their system and the severity of the infection.

For healthy adults:  The doctor may prescribe antibiotics to help fight the infection.  The patient would need to finish the prescription and take them as directed.  Pedialyte or a rehydration liquid may also be suggested to help replenish the fluids lost and keep the patient hydrated.

For children:  If the child is healthy, the doctor may not prescribe any treatment and let the infection run its course.  If the child has a fever, he or she may be given acetaminophen (Tylenol) and rehydration liquids as well.

For special cases:  Infants, the elderly, and people with weakened immune systems, antibiotics may be prescribed but the doctors may decide on a case-by-case basis.


The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

By:  Keeba Smith, Contributing Writer (Non-Lawyer)

July 29, 2018
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FDA and FSMA: An Update on Food Safety Procedures

The Food and Drug Administration (FDA) plays an integral, comprehensive, and critical role in ensuring food safety at various and interchanging levels. Its regulations are the guidelines to which every state adheres and adapts to their own standards of operation and inspection.

Every four years, the FDA revamps and revises their ponderous volume of regulations known as the Food Code. In conjunction with the code is the Food Safety Modernization Act (FSMA), enacted by Congress in 2011 in order to shift national focus from the reactive to the proactive approach to foodborne illness. In other words, the new emphasis is from responding to food related illness to preventing them.

According to the FDA, “[The FSMA] recognizes that ensuring the safety of the food supply is a shared responsibility among many different points in the global supply chain for both human and animal food. The FSMA rules are designed to make clear specific actions that must be taken at each of these points to prevent contamination.”

Several Steps in the Right Direction

Again, the FDA mandated the creation of the FSMA to ensure a more proactive approach in the prevention of foodborne illnesses. Approximately 1 in 6 individuals suffer from various types of sickness caused by contamination as a result of pathogens every year, and the resultant social and economic impacts are substantial. The recognition of and driving force behind the mandates of the FSMA is the “dramatic expansion in the global scale and complexity of the food system.” Not only are there thousands of growers and food processors right here in the US, it is not inclusive of the thousands of the same on a global basis, employing diverse processes and extended supply chains. The intent of the FSMA is to elevate increased levels of assurances of food safety and consumer confidence in food supply safety. In essence, the FSMA is a concentrated and exacting template for constant and ongoing procedures within the established FDA food code. The food code needs to become a fluid, living set of rules that respond to the ever-changing landscape of the global food chain.

The Department of Health and Human Services Report on the FDA

Historically, one of the main criticisms of the FDA involves the speed at which the agency issues recalls following a foodborne illness outbreak. Prior to the 2011 enactment of the FSMA, the FDA did not possess the authority to issue a mandatory recall, although the agency could warn manufacturers of potential health risks. It was up to the identified food companies to recall the contaminated products.

In December 2017, the Office of the Inspector General of the Department of Health and Human Services (OIG) issued a report on the FDA’s performance with regard to its food recalls. The OIG is comprised of four integral offices designed to implement best practices for the health and welfare of beneficiaries served by the Department of Health and Human Services. In summary, the OIG delineated their findings regarding the FDA food recall procedures:

“FDA did not always have an efficient and effective food-recall process that ensured the safety of the Nation’s food supply. We identified deficiencies in FDA’s oversight of recall initiation, monitoring of recalls, and the recall information captured and maintained in FDA’s electronic recall data system, the Recall Enterprise System (RES). Specifically, we found that FDA could not always ensure that firms initiated recalls promptly and that FDA did not always (1) evaluate health hazards in a timely manner, (2) issue audit check assignments at the appropriate level, (3) complete audit checks in accordance with its procedures, (4) collect timely and complete status reports from firms that have issued recalls, (5) track key recall data in the RES, and (6) maintain accurate recall data in the RES”.

Essentially, it appears that these initial shortfalls on the part of the FDA are due to the sheer and overwhelming responsibilities of what it is charged to do with food safety. In limited defense of the FDA, the agency must adhere to established protocol and in its efforts to thoroughly investigate foodborne illness outbreaks, this thoroughness can be compromised. The sheer number of fact-checking procedures in accordance with regulatory measures can sometimes delay a recall for an extended period of time, especially when the recall is issued in conjunction with the Center for Disease Control (CDC). The enactment of the FSMA is pointed directly at the amelioration of these procedures in that it gives authority to the FDA to issue mandatory recalls rather than reliance on food producers and food distributors. When a recall is initiated, the FDA is informed about potentially dangerous food products via (1) a food company discovers a problem and contacts the FDA; (2) the FDA, upon routine inspection, determines the potential for a recall; (3) the FDA receives reports of health problems through various reporting systems that are varied and can be sporadic; and (4) the DCD contacts the FDA. Each of these discovery procedures inevitably involves various necessary protocols that often delay timely notification.

What’s at Stake?

There is an apparent juxtaposition as to the authority of the FDA, and what it deems best in terms of public food safety. There have been several instances wherein the FDA has issued recalls that, in retrospect, caused great economic impact to food companies when it was discovered that their product was adulterated with contaminants without intention to distribute. While scrambling to bring the damage under control, the FDA had swiftly issued recalls that eventually decimated the respective companies. It is a difficult conundrum to discern what it is in the best public interest when it comes to food recalls. This effect is best described by Luke LaBorde, professor of food science at Pennsylvania State University, “They’re trying to walk a fine line. They [the FDA] don’t want to be too fast on the trigger, because they’ve been burned in the past on issuing recalls. It’s a huge economic effect on an industry. It could wipe them out. But on the other hand, if people start dying, that’s even worse than the recall”.

By:  Kerry Bazany, Contributing Writer (Non-Lawyer)

July 28, 2018
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Blockchain and Food Safety – Are the Two Really Related?

Let’s talk blockchain. Wait a minute, don’t leave. I’m not talking about Bitcoin or Cryptocurrency. I’m here to talk about blockchain and our food system.

It’s not as scary as you think. Actually, once we understand the basics, we will see how amazing it is and what life-changing uses. For most, that word is scary. I get it; it was for me at first. Then, once I had a basic understanding, it made (a little) more sense. In part one of this two-part series we will be looking at what exactly is a blockchain, gaining a better understanding of how we can make it work for us, and how we can use it to be healthier. In part two we will dig deeper into how these advances in technology are already in place and the benefits of keeping us and our food safer.

Hold your nose if that’s your thing, we are about to dive into a world of technology. If at the end of this you still have questions, I will leave links to more in-depth reading. Trust me, it is exciting.

What the Heck is this Blockchain I Keep Hearing About?

At its simplest form, the Blockchain is a host of computers (nodes) connected for a common purpose. “The Blockchain is a public ledger where transactions are recorded and confirmed anonymously. It’s a record of events that is shared between many parties. More importantly, once information is entered, it cannot be altered.” (source)

Because the Blockchain is synonymous with cryptocurrency, there is some hesitation in reading and understanding further. All this cryptocurrency talk can be daunting at times but now with a basic understanding of what blockchain is at its core, the next step is exploring what it can do for food and food safety.

Remember before we go further: make the differentiation between blockchain and cryptocurrency now. For the purposes of this post, we care nothing about currency itself. We are focused on blockchain only.

This short video explains more on blockchain and how it works.


Important Keywords to Remember

  • Ledger – the record of transactions and accounts connected
  • Decentralized – spreading out of power to less concentrated areas
  • Proof-of-work – data that is difficult to produce but easy to verify
  • Real-time – information captured as it is happening
  • Distributed Database – storage devices not attached to a common processor
  • Peer-to-peer – network in which each computer can act as a server
  • Intermediaries – person acting as a link between people or companies

Take a minute and think about how this could relate to our food safety … I’ll wait.

Can you see it? This is the exciting part.

Food Safety and Blockchain

Part of the issue with food and possible contaminates is tracking. Yes, we have a responsibility to wash food, cook it properly, and wash everything before and after; but, do we really know where our food comes from? If agencies in control of finding out where tainted food originated from and getting to the bottom of mysteries surrounding outbreaks, having a ledger of every food product would go a long way.

E. coli has been in the news lately with multiple outbreaks countrywide. The latest being from Romaine lettuce. As of May 1st, 121 people have been infected with one fatality in California. Twenty-five states and a lot of questions the CDC finally found that the lettuce came from the Yuma, Arizona region. Then, it was linked to canal water contamination. But still, no one farm was implicated.

So, this is still an ongoing issue, and I will interject here: make sure you know where your Romaine lettuce came from and wash your food thoroughly.

Tracking a food product from inception to delivery and every stop in between would be groundbreaking. As of the writing of this article, Wal-Mart has implemented such a program. Of course, this technology is in the infancy stage with many unforeseen problems ahead. But only time will tell if this is going to help consumers feel safe when buying products and keep businesses transporting the product honest.

The Downside – Or is it?

Believe it or not, there are those who want nothing to do with Blockchain and what it could do for consumers. I do not fault their opinions but I believe there is a bigger picture here we need to focus on and consider.

Intermediaries, those “middle-men” who make a living working for both sides could be hit the hardest. Being the sole provider of trust and process flow can be a large responsibility but also a detriment to those at the mercy of such agencies. By removing this middle-man, the Blockchain can improve trust, boost trade, and most importantly lower costs. This can cause thousands of jobs to be removed and that will need to be addressed at some point; however, the positives I believe outweigh the negatives.

You Don’t Have to be Scared Anymore

I know this is only the beginning for you and we barely scratched the surface. I will not lie – it is a tough concept to fully understand. I’m still learning every day. But now, with a basic understanding of what it is and how it works, it should be a little less scary.

Blockchain is a powerful tool and in the coming months and years will be utilized for many things we can only begin to think about. What is important is its staying power and ability to make our lives better. It may be wise to understand more as we usher into a new age with this technology.

In part two we will focus more on food safety and what the Blockchain can do for all of us.

In the mean-time, here are a few resources to further your reading and understanding. Never stop learning, even if the subject matter seems to be over your head. You may just surprise yourself. Don’t get discouraged if some of this information is deep at first. Hang in there for another article soon coming on this exciting new tech.

By: Dwight Spencer, Contributing Writer (Non-Lawyer)

July 28, 2018
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Getting the A+: Restaurant Inspections and Food Safety

Most of us really enjoy dining at restaurants. I know I do. But how can we be sure that the food we consume is safe to eat? With all the recent recalls involving everything from lettuce, meat, melons and even cereal, it can certainly seem exhausting to practice vigilance when it comes to food safety. This is why our trusty local health department and other federal agencies are here to help us make good (and safe) decisions.

The Powerful Agency That Safeguards Our Food: the FDA

The creation of the Food and Drug Administration dates back to 1927, when Congress charged the Department of Agriculture’s Bureau of Chemistry with the enforcement of the 1906 Food and Drugs Act. Initially, Congress split this bureau into two distinct agencies: one which handled regulations, and another to conduct experiments. By 1979, it was under the aegis of the Department of Health and Human Services.

But it wasn’t until the 1970’s that the FDA became the agency that we know today, after quite a few name changes, reorganizations, and even relocations. The tasks of this agency in its present incarnation are, of course, what interests us now, and the safeguarding of our food sources is of great significance today. We inherently place trust not only in the FDA, but a myriad of local and state agencies that are the final responsibility of the FDA to ensure that stringent guidelines are followed.

The FDA and Restaurant Inspections

The length and breadth of FDA regulations is extensive and exhaustive, as their regulations cover medical devices, cosmetics, veterinary products, tobacco, and biologics, such as vaccines and blood products. This is all exclusive of food regulation, so for the purposes of this article, we’ll focus on food: specifically that which is provided at restaurants and at food stores.

All restaurants that prepare food for public consumption are subject to health standard-based regulations. As consumers, we really don’t understand what goes into a restaurant inspection and how a particular food establishment receives it’s “grade.” Restaurants are required to post a letter grade that has been given by the local health department, and it’s important to understand how those letter grades are derived. A perfect score is 100, so a 90 to 100 point score is an A, 80 to 89 is a B, and so on. First and foremost is the local inspector’s evaluation as to a restaurant’s effectiveness in measures to prevent any instances of foodborne illness, such as the presence or absence of improper holding temperatures, inadequate cooking procedures (for example, undercooking raw eggs), contaminated equipment, food deriving from unsafe sources, and poor personal hygiene. Additionally, inspectors must ascertain certain risk factors according to the type of food served, e.g. an establishment that provides deli sandwiches but does not cook food is considered a lower risk than say a fast food restaurant that serves hamburgers (raw meat), and especially a sushi bar that provides uncooked or undercooked seafood.

Another factor that inspectors closely examine is the inspection and compliance history of each restaurant, meaning the more recent a violation, the more frequently it undergoes inspection. It perhaps goes without saying that establishments that are associated with known foodborne illnesses or outbreaks are inspected most often.

What Restaurant Proprietors Can Expect from an Inspection

An inspector arrives at a restaurant establishment, clipboard or smart phone in hand, and begins his or her inspection with a score of 100 and starts deducting points from there. Essentially, the procedure goes something like this:

The Kitchen

  • The kitchen is inspected for proper employee hygiene. Workers must rinse, soap, scrub for at least 20 seconds, and dry off with a one-use towel. They must also use gloves and hair protection, and not be on duty if they are ill or have open cuts.
  • Additionally, raw meat and fish are tested using a digital thermometer to ensure that they are being cooked to the right temperature (160 degrees F for ground beef, 145 degrees F for fish. The inspector will then turn his attention to the freezer and refrigerator for proper storage temperatures (zero degrees F for freezers, and 40 degrees F or below for refrigerators).
  • Inspectors observe how food is prepared in order to catch any instances of cross-contamination. This means that knives, cutting boards, utensils, and especially hands that are used in handling raw meat are separated from ready-to-eat food. The food must be properly washed and sanitized. Processed ingredients must be properly stored and come from licensed commercial kitchens.

Other Areas

  • There are, of course, other areas to inspect, known as the static areas: the areas that don’t change very much. This would include dishwashing equipment and sinks, employee and customer restrooms.
  • The storage and labeling of toxic cleaning products are critical as well. So are the proper functioning of HVAC systems and smoke detectors.
  • Inspectors will check for the cleanliness of the dining tables, the floors, and the walls and ceilings. Even the dumpster and other trash receptacles are checked.

What Constitutes a Major Violation

Many violations are minor and are worth only a one point deduction, such as unclean or unkempt furniture or an open condiment bottle. Major violations can directly impact the safety of the restaurant’s food, such as:

  • Unsafe food source
  • Improper storage of food (hot or cold)
  • Improperly cooked food, especially undercooked
  • Cross contamination
  • Presence of sick restaurant staff

Because a restaurant’s inspection grade score may be an “A”, it is still good practice, as a consumer, to be vigilant. A score in the A range may not indicate a sparkling clean and pristine eating establishment, as evidenced by the fact that the restaurant could indeed have several violations, some minor, but also a major violation (worth four points) and still be issued an A grade. However, violations such as an insect or rodent infestation, or lack of hot water, will be cause for an immediate shut down. For those interested in real-time inspection reports of their local restaurants, there is an app called whatthehealthapp.com. It includes the restaurant’s inspection scores as well as the types of violations.

By:  Kerry Bazany, Contributing Writer (Non-Lawyer)

July 27, 2018
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